BACKGROUND AND OBJECTIVES: Decision making in case of acute appendicitis may be difficult, especially for junior surgeon. Radiological investigations do not appear to be helpful sometime. A decision to operate based on clinical suspicion alone can lead to removal of normal appendix in 15-30% cases. In some studies Modified Alvarado Scoring System (MASS) was helpful in minimizing unnecessary appendectomies. The present study aims to evaluate the efficiency of Modified Alvarado scoring in preoperative diagnosis of acute appendicitis. METHODS: A 100 consecutive patients suspected of acute appendicitis who were admitted, investigated and treated were taken for the study. They were prospectively evaluated using the modified Alvarado scoring (MAS) to determine whether or not they had acute appendicitis they were assigned in three groups they were treated accordingly. The MAS was correlated with operative and histopathological findings. RESULTS: The results of the study showed that high score in men and children (7-9) had a sensitivity of 95.45% and 87.50& respectively, where in females it had a sensitivity of 76%. The score (5-6) in men and females had a sensitivity of 57.14% and 75% respectively. INTERPRETATION AND CONCLUSION: the high score in Modified Alvarado Score Is dependable aid in the early diagnosis of acute appendicitis in men and children but is a less dependable aid as far as women are concerned.
The primary goal of total hip arthroplasthy is to improve pain and function. This study was conducted at department of orthopaedics, Kamineni academy of medical sciences and research centre, Hyderabad during January to December 2017 after obtaining permission from hospital ethics committee. This study includes 30 patients which were divided into lateral and posterior approach groups each consist of 15 members. The mean age was 55 years. It includes 17 males and13 females. The duration of surgery in lateral and posterior approaches were 128 and 95 minutes respectively. functional outcome were assessed postoperatively in both the lateral surgical approach group patients and posterior surgical approach group patients using the Harris Hip Score system to evaluate pain and function. The significant improvement was appreciated in the posterior group when compared to lateral group. Trendelenburg test was assessed preoperatively and postoperatively. Although, there is more improvement in the posterior group than the lateral, the p value was not significant. Electrophysiologial study was normal both preoperatively and postoperatively in both groups and hence not significant. The mean Rivermed gait score in posterior approach group were 2.70 and mean Rivermed gait score in lateral approach group were 3.0.There is better improvement of gait in posterior approach group than the lateral approach group. Horizontal and vertical femoral offset ratio were evaluated postoperatively, in both lateral surgical approach group patients and posterior surgical approach group patients using the radiography which was comparable in both groups. Post operative complications like posterior dislocation of hip was observed in one case of posterior approach and Trendelenburg positive score was observed in 4 cases of lateral approach. This study concludes that both were found to be good and any of them can be selected for the total hip arthroplasthy.
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